Provider Demographics
NPI:1023664893
Name:KAMARA, ISHMEAL
Entity type:Individual
Prefix:
First Name:ISHMEAL
Middle Name:
Last Name:KAMARA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9308 CHERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740-1272
Mailing Address - Country:US
Mailing Address - Phone:301-204-5944
Mailing Address - Fax:
Practice Address - Street 1:9308 CHERRY HILL RD
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-1272
Practice Address - Country:US
Practice Address - Phone:301-204-5944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide